We were astonished by readers’ responses to our recent article, “Employees are Sick of Being Asked to Make Moral Compromises.” Many told us they finally had accurate language to describe an experience that felt painfully familiar. And more commonly, many asked for advice on what to do if they’d experienced a moral injury.
To recap, moral injury is a traumatic response to witnessing or participating in workplace behaviors that contradict one’s moral beliefs in high-stakes situations. Injurious events typically include transgressions by others, such as managers or coworkers; transgressions individuals commit themselves; and betrayal. Here, we’ll dig into the definition of moral injury and the harm it can cause, then provide several strategies for coping with it.
A Continuum of Harm
It’s important to note that many upsetting workplace situations do not rise to the level of moral injury. Morally injurious situations are high stakes and carry the potential of physical, psychological, social, or economic harm to others — for example, allowing workplace bullying to damage a health employee, manipulating vulnerable customers into overspending that could leave them in financial peril, and denying lifesaving care to patients. Moreover, as with any stress reaction, moral events (such as being forced to lie) must be distinguished from moral reactions (such as the feeling of guilt).
The emerging scholarship on reconciling the various terms used to describe responses to moral events points toward a continuum of moral harm. Of course, the complexity and variety of moral situations make any classification imperfect. Situations involving committing moral transgressions are more likely to lead to shame and guilt, while being a victim of betrayal is more likely to result in anger or sadness. In addition, there are also individual differences in sensitivity to morally distressing events, which can be determined by both biology and experience. travel, here is a useful summary:
- Moral challenges are isolated incidents of relatively low-stakes transgressions. For example, workers might be instructed to use lower-quality materials in creating a product (eg, substituting a non-organic product when running out of organic). A manager may require an employee to stay late, as a rare exception. This may result in a somewhat distressing but transitory “moral frustration,” with moderate levels of anger or guilt.
- Moral stressors can lead to more significant moral distress. This may involve more substantial and/or regular moral transgressions — for example, a manager pushing employees to stay late several times each month, or an HR professional administering a morale survey knowing that the results will never be used, just like all the previous surveys . A dental practice may upsell patients on unnecessary, but not harmful treatments. This may result in negative moral emotions that are bothersome and might be lasting, but do not interfere with daily functioning. (However, in some nursing research, the experience referred to as “moral distress” is seen as very intense, possibly meeting the criteria for moral injury).
- Injurious events are the most egregious. Executives could pressure a manager into manipulating burned-out employees to regularly sacrifice their time off and well being, while the organization intentionally keeps positions open for months. A health care worker might be required to provide medical treatments that are likely to lead to more treatments even though a cure is available. Situations like these could result in a highly distressing moral injury in which negative moral emotions are sufficiently intense and frequent to interfere with daily functioning. In particular, a person may experience intense shame leading to self-isolation or self-harm, or may quit their job in disgust. This level of moral stress response is similar to and at least partially overlaps with post-traumatic stress disorder (PTSD).
Strategies for Coping with Moral Injury
While the ultimate responsibility for preventing moral injury rests on organizational decision-makers, individual employees are often forced to deal with the consequences on their own. Our advice is directed to those who must take care of themselves while their employers put them into situations of moral harm. If your conscience has been wounded, even by your own hand, here are some places you can begin your process of restoration.
Confront denial and listen to your pain.
The pain of moral injury makes it tempting to minimize its reality. Denial can be a comforting mechanism for coping and enduring. But over time, that instinct to survive can lead to organizational Stockholm syndrome, where we actually bond with our abusive environment, dismissing its harmful effects. We suppress pain signals like anxiety, sadness, guilt, and self-doubt.
If you find you’re saying things to yourself like, “She probably didn’t mean it that way” or “He’s just having a rough week again,” take heed. Giving people the benefit of the doubt is fine … once or twice. But if a pattern of behavior leads to destructive outcomes for others, it’s time to acknowledge to yourself that you’re in harm’s way. Denial can put a balm around our moral center to keep it from feeling the shame and outrage. But that moral pain serves as a powerful messenger, alerting us that the health of our conscience is in jeopardy. Facing the harm we’ve incurred — and the harm we may have helped inflict — is the first step toward moral healing.
Engage in “soul care” as self-care.
Moral injury has been described as “the wounding of the soul.” Healing the soul requires a particular kind of attention. Unlike the self-care often associated with pampering oneself, indulgences don’t quite reach the soul.
One of the greatest releases of emotional pain comes from a vulnerable, honest conversation with a trusted professional. A coach, therapist, or other mental health professional trained in dealing with trauma responses can help guide you through an exploration of the pain you’re feeling. If access to professional help is difficult, at least consider journaling a detailed account of your struggle.
One executive Ron coached while she was on sabbatical talked vulnerably about her abusive boss and the harsh treatment she gave to her team in turn. The mixture of guilt and shame, resentment, and fear that her career could never be fulfilling again had her emotionally paralyzed and withdrawn. Carefully parsing out each aspect of her pain led to creating a plan to reassess her personal values, make amends with those she’d harmed, and work through forgiveness of herself, her boss, and the culture that enabled so much harm. It was a safely guided process that bolstered her courage to be truthful with herself. She even uncovered the origins of her own story that made her vulnerable to such an environment. Restoration isn’t a quick process, but if you want to leave behind the remnants of moral injury, you’ll need to commit to making the process a priority.
Avoid vengeful and entitled reactions.
The bitterness of moral injury can make us crave revenge. But be assured: Any momentary satisfaction will be short-lived. No matter how justified you feel, you’ll still just be compromising the very values that were injured to begin with. In some moments, you may risk reaching a boiling point and reacting to someone responsible for causing your moral harm. If you spend a lot of time envisioning the punishments you feel your moral injurer deserves, exasperated with how long they’ve gotten away with their destructive behavior, that’s a dangerous sign you’re accumulating ill will. At the most inopportune time, that ill will could erupt in an angry outburst, an emotional crisis, or a sudden downturn in your mental health.
Learning to self-regulate is critical to steering clear of acting impulsively. Deep-breathing regimens for reducing stress can be very helpful in such moments. Having a close confidant, mentor, or coach to call on short notice can also be useful. One client Ludmila worked with found it both comforting and trigger-reducing to have a short phrase to repeat to himself in moments when his boss acted callously or unfairly. The phrase reiterated some of his core values of compassion and kindness, reminding him of who he aspired to be even in the face of others who didn’t behave that way. Reconnecting to our core values helps us rise above stooping to the low levels of those we resent.
Determine what role forgiveness can play.
Determining if and how to choose forgiveness when your conscience has been wounded can be complicated. It first requires you to step back and explore your relationship to this oft-misunderstood value.
First, remember what forgiveness is not. It is not the restoration of trust. It doesn’t require that you be in a close relationship with the person or system you’re forgiving. It simply means you’re letting go of your bitterness and desire to retaliate for the harm incurred. It means, as Dr. Mark Goulston says, “Accepting the apology that you are never going to receive.” It’s a forfeiture of your anger as a source of motivation. And it’s not a one-time event where you simply declare, “Fine, I forgive them.” Forgiveness is a process. It’s a daily set of deep choices to engage the emotions that flood your mind at inopportune, unexpected times, and then release them. Then, it means letting go of expectations that the person or organization will show any remorse for their wrongdoing.
You can be sure that clinging to bitterness and the dark motivation it can provide is destructive to your emotional and physical health, including raising your likelihood of experiencing PTSD. Forgiveness is difficult, but necessary for full restoration from a moral injury. And many find the most difficult person to forgive is themselves.
Shed shame to restore your moral center.
One of the most painful discoveries of grappling with moral injury is the harm we’ve inflicted. One executive Ron coached had been responsible for setting up surveillance software and monitoring the productivity of employees working from home during the pandemic. He then provided reports to bosses whose people weren’t online for the number of hours the company is deemed sufficient. He confessed:
I felt horrible. I was spying on people who were burning out trying to keep pace with all the demands on their lives, or creat[ing] the illusion of being online when they weren’t. I should have pushed back on my boss when they wanted to implement this, knowing it was wrong. Our people have never let us down and I knew they wouldn’t now. But once they found out they were being tracked, the whole thing became a game.
His guilt was so paralyzing that his health deteriorated, and he ended up having to take medical leave. Trust was a sacred value to him, and he’d felt like he irreparably violated it. Over time, he was able to separate out what was his responsibility and what was the organization’s. He accepted the things he did and didn’t do in order to shed regret and shame. He reigned his convictions about why trust was so important in the workplace. He ended up leaving the organization.
Change your situation.
We cannot heal in the same situation where the injury keeps occurring. We also cannot restore our conscience while continuing to violate our values. Sometimes we can still do good work even if our larger organization is far from perfect. Sometimes we can individually make amends, or even help change our organization. For example, we can help create new regulations to address overwork or surveillance. But if it’s not possible to do your job without continuously violating your values, leaving the situation or organization is a necessary step.
. . .
Moral injuries can leave lasting impacts on our psyche, but they don’t have to remain debilitating. Like other trauma and hurt, we can grow from them. We can find the resilience we need to rise above the injury and restore our moral centers. Sometimes we’re able to take the environments along on that journey, and sometimes we have to leave them. Either way, if you’re carrying the weight of moral injury, don’t wait until it overtakes your whole outlook on life, and yourself. Find the courage to face what you’ve experienced and done, and with it, reclaim the values you hold most dear.
here. You may also use this form to submit comments on this article directly to the authors.